4. Maintain a health journal for your dog to record which treatments you try, at what dosages, and how well they work for your dog.

Osteoarthritis is the number one cause of chronic pain in dogs, affecting one in five adult dogs, with the incidence more than doubling in dogs seven years and older. It is a degenerative disease that causes pain, loss of mobility, and a decreased quality of life. Dogs can develop other types of arthritis too: rheumatoid arthritis, septic arthritis, spinal stenosis, spondylitis, or spondylosis. Signs of canine arthritis include stiffness when getting up or lying down, limping, slowing down on walks, pain after exercise, or reluctance to jump or climb steps. It’s important to recognize the signs of arthritis in dogs and begin treatment early, to slow the progression and help preserve your dog’s quality of life. Find a complete list of dog arthritis symptoms and risk factors by reading "Identifying Arthritis in Dogs," by CJ Puotinen.

So, your dog has just been diagnosed with osteoarthritis. Now what? To start things off, here are the do's and don't's.

Maintain exercise but change long walks to more frequent, shorter walks.

Consider nutrition. The best dog foods for arthritis are papaya, alfalfa, celery, and ginger.

Raising water and food bowls can reduce strain in the neck or back of an arthritic dog; some arthritic dogs may not eat or drink as much as they should without this sort of accommodation. Note, however, that raised bowls are contraindicated for dogs who are prone to bloat. Ask your veterinarian whether your dog is at risk for bloat.

Put carpet runners on hardwood floors. Try to prevent your dog from slipping, as this creates unwanted stress on the entire body.

Provide a soft, supportive bed.

Keep nails trimmed. If nails are too long they can change the gait on the dog, causing skeletal changes and arthritis in the foot/toes.

Use a ramp where needed (for helping your dog get in and out of the car, on to your bed or sofa, etc.). This will reduce strain on his knees and hips.

If your dog is having trouble getting up or walking on his own, check out slings, rear-end harnesses, wheelchairs, or carts to help keep him moving.

Consider physical, laser, and massage therapy, acu-puncture, and dog arthritis supplements. All or a combination of these will improve the quality of your arthritic dog’s life.

DON’T:

Self-diagnose your dog with arthritis.

Force an exercise regimen that your dog is not comfortable with.

Try any stretching of limbs without being properly trained.

Discontinue exercise. A certain amount of exercise remains important for your arthritic dog; it is necessary to help maintain muscle strength and mobility.

Ignore your dog’s extra weight. Your dog will feel so much better after taking that extra burden off sore joints.

Ignore sliding or falling. Don’t underestimate how damaging continual sliding and falling can be on the arthritic dog’s body.

Give any medication without veterinary approval.

When my dog, Piglet, was diagnosed with severe dysplasia in both elbows at a year old, I was told that, even with the surgery we did, she would develop arthritis in those joints. I gave her a daily glucosamine supplement, but knew of no other way to help her. By the time she was six, she was on daily NSAIDs (non-steroidal anti-inflammatory drugs, such as Rimadyl and Etogesic) to relieve the pain that otherwise caused her to limp. At the time, I thought I’d be lucky if she made it past the age of 10 before becoming too lame to walk.

Author Mary Straus' dog, Piglet, still happily takes long walks at age 15, in spite of her lifelong arthritis, thanks to a grain-free, raw diet; a variety of dietary supplements; regular, gentle exercise; and NSAIDs.

It was then that I learned about the benefits of a natural diet, and began researching dog supplements that I could use to improve her condition. I switched her onto a raw, grain-free diet just after she turned 7, and within a few months, she no longer needed any drugs for pain.

As time went on and her joints continued to deteriorate, I tried more and more supplements and natural therapies, rotating between those that seemed to help, and replacing those that didn’t seem to make a difference. I was able to keep her off drugs until she was almost 12, then began adding them to her nutraceutical “cocktail.” The net result? At age 15, her elbows are visibly deformed and vets cringe when they see her x-rays, but she still enjoys one- to two-hour walks every day. She no longer runs, but jogs along at a comfortable pace. I let her decide how far and how fast we go so that I don’t risk pushing her beyond her limits, but occasionally I have to convince her it’s time to head for home when we’re miles away and she still wants to keep going. Following are the arthritis treatments that have helped my dog, and others like her.

Homemade Dog Food for Arthritis Treatment

What do you give a dog for arthritis? Certain foods may increase inflammation and aggravate arthritis in dogs. Some people have found that eliminating grains from the diet improves their dogs’ symptoms, sometimes to the point that no other treatment is needed. In addition, plants from the nightshade family, including potatoes (not sweet potatoes), tomatoes, peppers (all kinds), and eggplant are known to aggravate arthritis.

Unfortunately, it’s not easy to avoid these foods unless you feed your dog a homemade diet, where you control all the ingredients. The vast majority of dry foods contain grains, and those that do not often contain potatoes instead. There are a few brands that use only sweet potatoes or tapioca that would be worth trying for a dog with arthritis, to see if your dog improves. Canned foods usually have fewer carbohydrates than dry foods, so that might be another option to try, especially for smaller dogs where the higher cost of canned food is not such an obstacle.

Certain foods may help with arthritis: celery, ginger, alfalfa, tropical fruits such as mango and papaya, and cartilage are all good to add to the diet of a dog with arthritis. Remember that vegetables must be either cooked or pureed in a food processor, juicer, or blender to increase digestabilty by dogs, and fruits are more easily digestible when overripe.

A few people have reported that organic apple cider vinegar (with the “mother,” a stringy sediment comprised of enzymes) has provided some benefit when added to food or water. Be sure your dog is still willing to drink water with the vinegar added if you try it, or provide a separate, plain water source.

Proper Weight and Exercise for an Arthritic Dog

It’s extremely important when dealing with a dog who has arthritis to keep him as lean as possible. Extra weight puts added stress on the joints, and makes it harder for your dog to get proper exercise. If necessary, get an inexpensive postal scale and weigh your dog’s food to help you control his intake.

Carbohydrates supply the same number of calories as proteins do, but offer less nutritonal value to dogs. A low-carb, high-protein diet is better for a dog with arthritis than one that is high in carbs, which is more likely to lead to weight gain. Keep fat at moderate levels, to avoid weight gain from a high-fat diet and excess hunger from a diet that is too low in fat.

If your dog needs to go on a diet to lose weight, remember to reduce portions gradually, so the body doesn’t go into “starvation mode,” making it harder to lose weight.

Moderate, low-impact exercise, such as walking or swimming, is important for dogs with arthritis, as regular exercise will help maintain flexibility and well-developed muscles help to stabilize the joints. It’s important to prevent your dog from exercising to the point where he is more sore afterward. Swimming is an excellent exercise for dogs with arthritis, as it is non-weight-bearing, so your dog can exercise vigorously without damaging his joints. If your dog is unused to exercising, start slowly and work up only gradually, as he begins to lose weight and develop better muscle tone. Several short walks may be easier on him than one long one.

Natural Anti-Inflammatories for Dogs

When your dog shows signs of arthritis, there are a number of natural anti-inflammatory supplements that you can try before resorting to medications. Herbal remedies for canine arthritis are plentiful as well; below is a list of herbs known to help dogs deal with the pain of arthritis.

First and foremost is fish oil, a source of the omega-3 fatty acids EPA and DHA, which reduce inflammation and provide other benefits to the body. Be sure to use fish body oil, such as salmon oil or EPA oil, not liver oil, which is high in vitamins A and D and lower in omega-3 fatty acids. (Also, liver oil would be dangerous at the high doses needed to fight inflammation).

Most fish oil gelcaps contain 300 mg combined EPA and DHA, and you can give your dog as much as 1 of these gelcaps per 10 lbs of body weight daily. If using a more concentrated product, containing 500 mg EPA/DHA, give 1 gelcap per 15-20 lbs of body weight daily. If using liquid fish oil, adjust the dosage so that you are giving up to 300 mg combined EPA/DHA per 10 lbs of body weight. Be sure to keep the product refrigerated so that it doesn’t become rancid.

You must supplement with vitamin E as well whenever you are giving oils, as otherwise the body will be depleted of this vitamin. Give around 100 IU to a small dog, 200 IU to a medium-sized dog, or 400 IU to a large dog daily or every other day. Vitamin E in high doses also has some anti-inflammatory effect.

High doses of vitamin C may help with arthritis. It’s best to use one of the ascorbate forms, such as calcium ascorbate or sodium ascorbate, rather than ascorbic acid, which is harder on the stomach and may be irritating to arthritis. Look for one that contains flavonoids as well, which also help to reduce inflammation. If desired, you can give vitamin C to bowel tolerance, which means increasing the amount every few days until your dog develops loose stools, then backing off to the next lower dosage.

Bromelain, an enzyme found in pineapples, has strong anti-inflammatory properties. It works best if given separately from meals (at least one hour before or two hours after). Its effectiveness may be increased when it is combined with quercetin, a flavonoid. There are many combination products available, or you can give each separately.

SAM-e (s-adenosylmethionine), a supplement that is used to support the liver, can also reduce pain, stiffness, and inflammation caused by arthritis. It works best when given apart from food, and when combined with a B-complex vitamin.

Other arthritis supplements for dogs that have worked include MSM, Duralactin (this product is derived from milk, so creates digestive discomfort in some dogs), and Wobenzyme. There are also some newer herbal blends being marketed as replacements for NSAIDs, including Kaprex from Metagenics and Zyflamend from New Chapter, but I have not heard much feedback on them. Some people have also reported success using the homeopathic treatments Traumeel and Zeel by Heel Biotherapeutics.

Herbal Remedies for Arthritis in Dogs

Humans have used herbs for medicinal purposes for thousands of years. We take herbal remedies in the form of teas, tinctures, capsules, poultices, rinses and oils. Certain herbs reduce inflammation and are particularly helpful to arthritic dogs and people alike. Some of the best ones to use for arthritis are boswellia, yucca root, turmeric (and its extract, curcumin), and hawthorn. Nettle leaf, licorice, and meadowsweet can also be used.

Note that willow bark is another herb often used for arthritis. It is a relative of aspirin that may be easier on the stomach, but should still not be combined with other NSAIDs.

While it is true that some of these herbs may cause some adverse reactions in some dogs and people, all of the ones listed below are easily found and considered quite safe for dogs. To see the complete list of herbs you can use on your dog for arthritis, see "Herbal Remedies for Your Dog's Arthritis Pain," by CJ Puotinen. Here are our top 10 herbs for arthritis treatment:

1. Arnica (Arnica montana)

A small alpine plant with yellow blossoms. The flower heads, made into tea, tincture, or massage oil, are anti-inflammatory and relieve the pain of bruises, sprains, arthritis, and inflammation. Arnica is used externally.

2. Boswellia (Boswellia serrata)

A large tree native to India, is a potent anti-inflammatory that effectively shrinks inflamed tissue by improving circulation and increasing synovial fluid viscosity. Boswellia may help alleviate pain and improve range of motion within a week of daily use, and may slow the progression of cartilage damage. A bitter herb, boswellia is usually taken in capsules.

3. Cayenne (Capsicum annuum)

2016’s official Herb of the Year (see “Cayenne for Canines,” WDJ May 2016). Its active ingredient, capsaicin, makes cayenne a contact rubefacient, which means that it increases circulation to sore joints and painful areas when applied topically. Capsaicin also acts as a nerve block, reducing pain. Cayenne is an important stimulant or catalyst herb that can be added in small amounts to blends, improving their effectiveness, or added to food or given in capsules.

Cayenne is a member of the nightshade family, and while most dogs appear not to be adversely affected by nightshades, some may be sensitive. If cayenne seems to worsen your dog’s arthritis symptoms, try avoiding not only cayenne but its nightshade cousins tomato, potato, eggplant, paprika and other peppers, tobacco, and the medicinal herb ashwagandha (Withania somnifera).

4. Comfrey (Symphytum officinale)

The most significant plant source of the cell-growth stimulator allantoin, which speeds the healing of wounds and even broken bones (comfrey’s common name is “knit bone”).

This tonic, anti-inflammatory herb is no longer recommended for internal use because its pyrrolizidine alkaloids (PAs) may cause liver toxicity, but comfrey tea can be safely applied as a rinse or poultice to inflamed joints or sore spines. Alcohol-based comfrey tincture can be applied to sore joints, injuries, muscle strains, and other painful areas.

5. Devil's Claw Root (Harpagophytum procumbens)

Native to South Africa, has anti-inflammatory properties, stimulates the lymph system, and is a detoxifying herb for the entire body. Devil’s claw is usually taken in capsules. Unfortunately, overharvesting and adulteration have made much of the devil’s claw sold in the U.S. of little value. To give devil’s claw products a fair trial, look for sustainable sources. This herb contains COX-2 enzyme inhibitors.

6. Ginger (Zingiber officinale)

A familiar spice in cooking and baking, is stimulating, warming, and anti-inflammatory. Ginger helps improve circulation and digestion, and it is often added to blends as a catalyst or stimulant herb.

7. Licorice Root (Glycyrrhiza glabra)

Contains anti-inflammatory compounds that reduce joint pain and other arthritis symptoms while improving digestion and respiratory function. In small amounts, licorice root has no adverse side effects, but in large quantities or with daily use it can contribute to hypertension, edema, and hormone imbalances. Products labeled “deglycyrrhizinated licorice” or “DGL” have had the problematic substance removed, though some of the herb’s benefits are removed along with it.

8. Meadowsweet (Filipendula ulmaria)

A perennial herb with anti-inflammatory, anti-rheumatic, rubefacient, and analgesic actions. Its leaves, root, rhizomes, and flowers contain volatile oils whose compounds may be oxidized into salicylic acid, which, when metabolized in the gut, act like an herbal aspirin. In fact, the name aspirin is derived from Spiraea, meadowsweet’s old botanical name. This product should not be combined with NSAIDs.

9. Turmeric (Curcuma longa)

Contains more than two dozen anti-inflammatory compounds, including six different COX‑2 inhibitors. By itself, curcumin – the component in turmeric most often cited for its healthful effects – is a multifaceted anti-inflammatory that can reduce arthritis symptoms. In human studies, turmeric extracts containing at least 20 percent curcuminoids are comparable in their effects to the drug ibuprofen. Combining turmeric with bromelain (the pineapple enzyme) provides even more impressive results.

10. Yucca (Yucca schidigera, Yucca spp.)

Contains saponins, soap-like chemicals that reduce pain, joint swelling, and stiffness. Yucca is a popular ingredient in animal feeds because it reduces unpleasant odors in urine and feces. It should not be used in large doses for extended periods because it can irritate the stomach lining and cause vomiting.

For best results, use products recommended for dogs, follow label directions, and instead of giving it every day, consider a two-day break from yucca every week and a week-long break every one or two months. Whole Dog Journal did a full analysis on the benefits of feeding yucca to arthritic dogs; read "Yucca Root for Canine Arthritis Pain," (June 2004) by Gregory Tilford.

All of Kay Jenning's dogs have arthritis: 14-year-old sheepdog Polly, 11-year-old Border collie Kiri, and even 4-year-old Ziggy, a German Shepherd who has elbow dysplasia. With natural supplements, though, all are active and comfortable.

Aromatherapy for Dogs with Arthritis

Medicinally useful plants can be distilled into essential oils for natural pain relief for arthritic dogs. Essential oils come from the leaves, stems, flowers, roots, seeds or bark of aromatic plants and are distilled with steam. The process separates the essential oil from the water it's bonded to, which is also used therapeutically and is known as a hydrosol.

The therapeutic properties of an essential oil or hydrosol do not come from its scent, but rather from the constituent chemicals making up that oil. Essential oils are thought to contain anti-bacterial monoterpene alcohols or phenylpropanes, stimulating mono-terpene hydrocarbons, calming esters or aldehydes, irritating phenols, stimulating ketones, anti-inflammatory sesquiterpene alcohols, antiallergenic sesquiterpene hydrocarbons, and expectorant oxides. It is important to educate yourself thoroughly on using a therapeutic oil before trying it on your dog, and to find the highest quality herbs and oils.

Here are the ways you can administer essential oils to your dog safely and effectively:

1. Send them into the air with an electric nebulizing diffuser (available from aromatherapy supply companies).

2. Add a few drops to a small spray bottle of water and spritz it around the room, being careful to avoid wood or plastic surfaces and your dog’s face.

3. Place a drop on your dog’s collar, scarf, or bedding.

4. Place two drops on your hand; then rub your palms together and gently run your hands through your dog’s coat.

5. Add 15 to 20 drops of essential oil to eight ounces (1 cup) of unscented natural shampoo, or add one drop to shampoo as you bathe your dog.

6. Add two to five drops essential oil to a gallon of rinse water, shaking well before applying (avoid your dog’s eyes).

Other Natural Arthritis Relief Therapies for Dogs

Dogs with arthritis often respond to acupuncture and chiropractic treatments. Massage therapy can also be very beneficial, and is something you can learn to do yourself at home. Read "Pain Relieving Massage Therapy for Dogs," by Paulette Jolliffe (CMT, CCMT) to learn about the ways massage therapy helps arthritic dogs. Hydrotherapy, which uses warm pools or underwater treadmills to remove weight on a dog's joints (allowing for exercise), is becoming increasingly popular and can be very helpful, particularly for dogs recovering from surgery or injury. "The Benefits of Hydrotherapy for Your Dog," by CJ Puotinen, offers more information about this potential arthritis treatment for dogs.

If acupuncture helps your dog, you may want to consider gold bead implants, which are a form of permanent acupuncture. Many dogs respond to chiropractic treatments, which can be especially beneficial if your dog tends to become “misaligned” due to favoring one limb.

Warmth can help reduce arthritis pain. Applying a heat pack creates vasodilation and increases nutrient and oxygen delivery to tissues, which aids in the repair process of a dog's joints. Heat helps the muscles relax, will soothe your dog, and can improve your dog's range of motion. Apply a hot pack for 15 to 20 minutes at a time at times when your dog is stiff or after any swelling has gone down. Use hot packs before going on walks to loosen your dog's gait and help him move.

Equally helpful are cold packs, which you should use on your dog when his joints are so inflamed you can feel heat radiating from them, or when if he suffers from arthritic muscle spasms. Cold packs decrease swelling and inflammation and numb the pain from arthritis. For instructions on making your own cold or hot packs, click here.

Thick, orthopedic beds that insulate your dog from the cold floor or ground as well as cushioning the joints provide a lot of comfort. Whole Dog Journal reviewed "The Best Orthopedic Dog Beds," in March 2016. You'd be surprised at what a difference a good, supportive dog bed can make when dealing with arthritis. If you are considering a heated dog bed, just be sure the cords cannot be chewed. To check out other devices designed to help disabled dogs, "Orthopedic Equipment for Dogs Designed for Increased Mobility and Extra Support," is a good place to get started.

One more alternative treatment for arthritis in dogs is electric shock wave therapy (ESWT), which still remains a largely experimental medical treatment but which has been shown to relieve the symtoms of a large group of canine conditions. The shock waves appear to relieve pain and stimulate healing within the injured joint tissue, although the mechanism for these effects is unclear. Researchers believe that ESWT stimulates the body's own resources to speed healing, including increasing vascularization (blood supply) to the area being treated. Note that shock waves do not slow the progression of osteoarthritis in dogs, but rather reduce the pain that comes with it. Click here to read the full report on ESWT for dogs.

Arthritis Medications for Dogs

Glucosamine and Chondroitin for Dogs

The most common method of treating canine arthritis is the use of nutraceutical supplements called glycosaminoglycans (GAGs), also known as mucopolysaccharides. These include glucosamine (both the sulfate and the HCl forms) and chondroitin sulfate, from sources such as chitin (the shells of shellfish), green-lipped mussel (perna canaliculus), and cartilage. Also included in this category are the injectable forms sold under the brand names Adequan in the U.S. and Cartrophen (pentosan polysulfate) elsewhere.

"Using Glucosamine to Prevent Canine Osteoarthritis," by Lori Long offers a detailed analysis of GAGs and their relationship with arthritis. Although GAGs are usually the go-to treatment for arthritis in dogs, it is important to fully understand how these supplements work, and how to properly administer them to dogs.

GAGs are important because they actually protect the joint rather than just reduce symptoms, by helping to rebuild cartilage and restore synovial (joint) fluid. GAGs may also have some preventative effect on arthritis, though this is speculative.

Oral GAG products may be most effective if given separate from meals, though it’s fine to give them with food if needed. Always start with high doses so that you will be able to tell whether or not your dog responds. If you see improvement, you can then reduce the dosage to see if the improvement can be maintained at a lower dose.

If you don’t see any change within three to four weeks, try another supplement. Different dogs respond differently to the various supplements.

Brands that have worked for dogs I know include Arthroplex from Thorne Veterinary, Syn-Flex from Synflex America, Synovi-G3 from DVM Pharmaceuticals, Flexile-Plus from B-Naturals, and K-9 Glucosamine from Liquid Health. You can also use products made for people that contain ingredients such as glucosamine, chondroitin sulfate, and green-lipped mussel. The use of manganese in the supplement may help with absorption.

Injectable GAGs may help even more than the oral forms, and may work even when oral supplements do not. It’s very important to start with the full “loading” dose, following the instructions in the package insert, before tapering off the frequency to the least that is needed to maintain improvement (often one injection per month). You should continue to use the oral supplements as well.

It is interesting to note that the label instructions for Adequan say that it must be injected IM (intramuscularly), while Cartrophen is injected sub-q (subcutaneously, which is less painful and easier to do at home). Many vets believe that Adequan works just as well when injected sub-q as IM, and I have heard reports from people who have used this method effectively.

A related product is called hy-aluronic acid. It has been used with horses for many years, and more recently with dogs. In the past, it had to be injected into the joint under anesthesia in order to be effective, but newer oral forms have been developed that also work. You can use products made for dogs, horses, or humans, such as Synthovial 7 and Hyaflex (made by Hyalogic), Trixsyn from Cogent Solutions, and K-9 Liquid Health Glucosamine & HA.

A lean dog will experience less strain on his arthritic joints, especially if he's a large breed.

DLPA for Canine Arthritis

Eventually, no matter what you do, your dog may require treatment for chronic pain. There is one more nutraceutical that can help with this: dl-phenylalanine (DLPA), an amino acid that is used to treat both depression and chronic pain.

The most common dosage range for dogs is 1 to 5 mg/lb (3 to 10 mg/kg) of body weight, but I have seen dosage recommendations as high as 5 to 10 mg per pound (2 to 5 mg/kg), two or three times a day. In humans, very high doses may cause numbness, tingling, and other signs of nerve damage, so be on the watch for any signs that your dog may be experiencing these if using such high doses. It takes time for DLPA to begin to work, so it must be used continuously rather than just as needed. Often, however, you needn’t continue to give DLPA daily once it has taken effect; sometimes it can be given as little as one week per month to retain results. It is safe to combine DLPA with all other arthritis drugs, but do not combine DLPA with MAOI drugs such as Anipryl (selegiline, l-deprenyl), used in the treatment of Cushing’s Disease and canine cognitive dysfunction, or amitraz (found in tick collars).

I use Thorne Veterinary’s Arthroplex, which includes DLPA, because it makes it easy to give the proper dosage for a small- or medium-sized dog, but you can use human DLPA supplements for larger dogs. They are available in 375 mg and 500 mg capsules.

Kay Jennings, who lives with three dogs in Bristol, England, has a young German Shepherd Dog who began limping as a puppy, and was diagnosed with elbow dysplasia. “I’ve kept my lad active and pain-free using just DLPA plus Syn-Flex, and my arthritic Border Collie too,” she says. “It’s so effective that they can both take it just every other week and its residual effect keeps them covered for the other week.”

Jennings also has a working sheepdog who required higher doses initially. “My Polly had to start at 1,000 mg a day (she weighs 45 lbs). I was about to write it off with her at 500 mg a day, assuming she was one of those for whom it doesn’t work. I found a starting dose of any less than 1,000 mg made no difference to her even after a couple of weeks. Once we hit the right dose it worked within three days, and after a few weeks I could reduce to a lower level (500 mg a day) that still provided relief. After several months at this level, I was able to reduce her further, to 250 mg/day, and even put her on the week-on-week-off schedule that has worked for my other dogs.

“I have to say, I’ve found DLPA to be remarkably effective: Polly is now 14, and doing better than she has for some time. Kiri, my Border Collie, has recently (at the age of 11!) started doing a bit of obedience again, and Ziggy, the GSD, is still totally sound and very active, when his vet was convinced he’d need NSAIDs for his entire life just to be able to get about.”

Painkillers for Arthritis Pain in Dogs

Several over-the-counter painkillers are safe for dogs to use, as well as some prescription medications. NSAIDs and the synthetic opioid, Tramadol, are just two of the options available to dogs who suffer from arthritis pain, and they are discussed below. For a complete overview of painkillers prescribed to dogs with arthritis, read the 2017 article "Prescription Drugs for Dogs' Arthritis Pain".

NSAIDs for Dogs

There is much controversy about the use of NSAIDs, such as Rimadyl (carprofen), Etogesic (etodolac), Deramaxx (deracoxib), Metacam (meloxicam), and aspirin. This is due to their potential for harmful side effects, which include not only gastric ulceration but also liver and kidney failure, leading to death in some cases, sometimes after only one or two doses.

While there is no doubt that these drugs can be dangerous, they do have their place in maintaining quality of life when nothing else works. Inflammation creates a vicious cycle, breaking down cartilage and causing pain that restricts activity, which leads to weight gain and muscle loss, further restricting your dog’s ability to exercise and enjoy his life. Natural anti-inflammatories can do a great deal to help, but in the end, they are not as powerful as drugs.

Gunner, an 11-year-old rottweiler, has suffered from arthritis since the age of two. Fish oil and yucca kept him sound until a couple of years ago; now he also receives tramadol for pain.

There are precautions you can take to make the use of NSAIDs safer, though you cannot eliminate their risk. First, it’s always a good idea to have blood work done before starting any NSAID, and every few months thereafter when using them regularly, to check for underlying liver or kidney disorders that would contraindicate their use.

Second, you should always give NSAIDs with food, never on an empty stomach, to help prevent the gastric ulceration that is a very common side effect. Third, never combine NSAIDs with each other, or with prednisone, which greatly increases the chance of ulcers and other dangerous side effects.

Fourth, discontinue immediately and contact your vet at the first sign of any problem, which may include lethargy, lack of appetite, drooling, vomiting, diarrhea, difficulty swallowing, jaundice (yellowing of the whites of the eyes), increased drinking and urination, or any behavioral changes such as aggression, circling, or ataxia (loss of balance or coordination).

Last, be very cautious when switching from one NSAID to another. If possible, wait at least a week in between, particularly if switching from one of the non-COX selective products, such as aspirin, to one of the newer, COX-2 selective drugs, such as Deramaxx.

Anecdotal reports indicate that Rimadyl and Deramaxx appear more likely to cause serious problems when first started than other NSAIDs. Be particularly watchful if you use either of these drugs, or ask your vet for another option.

There is also a drug you can give to help reduce the chance of gastric ulcers, called Cytotec (misoprostol). This is a human drug that can also be used for dogs. It helps to mitigate the effects of COX inhibition that are responsible for damage to the intestinal lining by NSAIDs.

Another prescription medication that can be helpful is sucralfate, which is used to heal ulcers. Sucralfate interferes with the absorption of all medications, so it must be given at least two hours before or after you give other meds. Herbs such as slippery elm and marshmallow may also help to protect the stomach and intestines, though they’ve never been tested specifically with NSAIDs. One product that contains both is Phytomucil from Animal’s Apawthecary.

Tramadol for Dogs

When drugs are needed, ask your vet about using tramadol (Ultram), a synthetic opioid that provides arthritis relief for dogs without sedation or addiction and is safer than NSAIDs. Tramadol can be used in place of NSAIDs, though it is mostly for pain and has limited anti-inflammatory effect. It can also be combined with NSAIDs to increase pain control or lower the dosage needed, or pulsed periodically to give the body a break from taking NSAIDs.

Tramadol can be given continuously or used on an as-needed basis. It is less likely to create dependence than narcotics, but you should still wean off slowly rather than discontinuing abruptly if used long-term. Tramadol can cause constipation; if this is a problem, you can give your dog a stool softener to help. I’ve found that the price of tramadol varies significantly; Costco has the best prices I’ve seen (non-members can order prescriptions from Costco and they will ship for $2).

Gunner is an 11-year-old Rottweiler belonging to Sheila Jones of Highland, Michigan. He was diagnosed with elbow dysplasia at age two, and originally put on Deramaxx as needed, but was later switched to fish oil and yucca, which helped until a couple of years ago, when he became lame and needed something more to control his pain.

“I started him on tramadol at a low dose, but have worked up over time to 150 mg twice per day, and I add yucca root extract in liquid form when he needs an additional boost,” Jones says. “He also gets 2,000 mg of vitamin C twice per day.”

Jones is pleased with how well tramadol has worked for Gunner. “He is a little slow getting up in the mornings, but overall I believe he is doing very well. I am in contact with the owners of three of his littermates, and he seems to be doing the best of them. He still plays with our younger Rottie, and with his indestructible ball regularly. On days that he overdoes it, I give him a little extra tramadol.”

Note: Dogs should not take Ultracet, a combination of tramadol and acetaminophen (Tylenol), which can be dangerous for dogs.

Other Painkillers Used on Dogs

There are a few other medications that can be used for dogs’ chronic pain, when NSAIDs can’t be used, to decrease the dosage needed, or when more relief is needed. Most antidepressants, such as Elavil (amitriptyline) and Prozac (fluoxetine), offer some arthritis pain relief to dogs. Be careful about combining these drugs with Tramadol. See "Understanding Behavior-Altering Drugs,” for more information.

Amantadine is an analgesic for dogs that offers little in the way of pain control itself, but helps potentiate (increase the effectiveness of) other drugs used to control pain. Amantadine for dogs is inexpensive and can be used concurrently with Tramadol, NSAIDs, corticosteroids, gabapentin, and opioids. Neurontin (gapabentin) is an anti-convulsant medication also used to treat chronic pain. It can be combined with other medications, but is expensive.

When pain cannot be controlled in any other way, narcotics may be used. Hydrocodone can be combined with NSAIDs for greater relief. Vicodin (a combination of hydrocodone and acetominophen) is sometimes used, though acetominophen can cause liver failure in some dogs, and should not be combined with NSAIDs due to the danger of toxicity from acetominophen. Codeine can also be used, though it’s not as effective. Oxycodone or a fentanyl (Duragesic) patch can be used, but these are heavy narcotics, and are best used only for short periods, though even that may make a big difference. All narcotics are addictive, so they should never be used every day.

Lastly, there is some possibility that doxycycline may be helpful. This may be due to the fact that joint infection is common with arthritis, or because it has some anti-inflammatory effect of its own.

A Bright Future for Dog Arthritis Treatment

There are an endless number of supplements and therapies that claim to help with arthritis, but the ones noted here are those that, in my experience, have the best records of success. It’s important to keep trying different combinations to find what works for your dog, as each dog is an individual, and what works for one may be different from what works for another.

At age 15, Piglet is on a grain-free raw diet. I also give her Arthroplex (which includes glucosamine, green-lipped mussel, DLPA, boswellia, bromelain, and vitamin C), high dose fish oil, turmeric, SAM-e, and vitamin E daily. I alternate between giving her herbal Senior Blend and Alfalfa/Yucca blend (both from Animal’s Apawthecary). I give her Metacam, and one dose of tramadol daily to help with walks. She is also on sertraline (Zoloft) for anxiety, which may help with pain as well.

This combination of natural arthritis treatment and conventional treatment has kept my dog, Piglet, going for years longer than I thought she would - longer even than I dared hope. She is staring at me now, reminding me that it’s time for her walk, still the highlight of her day, and something she insists upon, even when it is pouring down rain. I am delighted to oblige.

Mary Straus does research on canine health and nutrition topics as an avocation. She is the owner of DogAware.com and lives in the San Francisco Bay Area with Piglet, her 15-year-old Chinese Shar-Pei.

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Comments (27)

I'd like to add information regarding the use of amantadine as a supplemental treatment to NSAIDS. People need to understand that there are serious side effects to the use of this drug. Many dogs experience agitation, anxiety, restlessness. For many, these symptoms go away after a short period. But for some, they do not.

Cooper, my flat-coat/newfie mix is 11-12 years old and has significant osteoarthritis and weakness in this back legs. Meloxicam was not fully helping with the pain, so we added amantadine. Weeks later, he experiencing severe anxiety, excessive whining and whimpering, roaming, restlessness - and those symptoms are not abating. I have taken him off the drug (my vet advised I do not have to taper off, but I can find no information one way or another). It's been 2 days and he is still agitated. I've begun giving gabapentin - which will hopefully also help resolve some of the agitation.

In human medicine, it is indicated that this drug may be contraindicated for persons with mental disorders. Many older dogs begin to develop Canine Cognitive Dysfunction. My concern is that CCD is not considered when prescribing amantadine - and that it will exacerbate the CCD symptoms.

I'm hoping this drug did not do irreversible damage to my dog's condition. I just want others to be aware of this potential risk.

I was diagnosed in June, 2013 with OSTEOARTHRITIS of the spine and both knees, symptoms started with severe back pain, joint swelling and stiffness in my knees and eventually the feeling spread to my shoulders and neck, i couldn’t lift my arm without pain medications. I was prescribed tramacet and arcoxia for 8 months but had to stop them due to bad effects. In 2017, I started on OSTEOARTHRITIS HERBAL FORMULA from RICH HERBS FOUNDATION, this natural herbal treatment reversed my osteoarthritis. Visit ww w. richherbsfoundation. c om. The treatment worked incredibly for my arthritis condition.

I was diagnosed a year and a half ago with Lyme disease after three months of flu-like symptoms and severe knee and foot pain. Finally, after several tests and an expensive MRI, I was diagnosed. I was put on doxycycline and had a severe reaction to that, so then they put me on a different medication. My pain still didn’t go away for good. I still had bouts of pain and fatigue that last weeks. I was seeking something to help regain my life to be able to do things for myself. Through my primary physician i learnt about a Lyme disease herbal formula from NATURAL HERBAL GARDENS and their success rate with the treatment, i immediately started on the Lyme disease herbal protocol, I am glad to report the herbal formula worked effectively and there was no side effects, I had a total decline in symptoms, the pains, chronic fatigue and other symptoms stopped, my Lyme disease is totally REVERSED, Here is a link to the website we ordered from ww w.naturalherbalgardens.c om This Herbal Protocol is Incredible!!

Amazing article.While not all forms of arthritis are preventable, you can help reduce your dog’s risk as well as the severity of the disease by ensuring that your dog gets plenty of appropriate low impact exercise, eats properly to support slow growth in puppies and to maintain lean body weight, and that you contact your veterinarian early if you think your pet may have arthritis.Supplements are very essential for treatment of dogs from various health issues.I have been using supplement like pet bounce for my 8 years old dog who was suffering from arthritis.It turned out to be very effective as it is a natural pain relief for dogs.

Mason Noah
I was diagnosed with RA at age 50. Now I'm 55 and I was in pain constantly, not to mention the intense fatigue. I was on Remicade, Arava, folic acid, and Percocet. It started in my neck and spread to both hips, hands, feet, back and just in the last two months, to my knees. I purchased RA herbal remedies online from a great herbal home called GOOD HEALTH HERBS HOME,I only used the herbal remedy for 5 weeks, my RA disappeared.pleases anyone out there going through RA pain don't hesitate to purchased RA herbal remedy from GOOD HEALTH HERBS HOME,contact details www .goodhealthherbshome .com . I am so grateful i find a miracle cure. I feel like i am 30 years old now,am so strong and healthy ..

I have been dealing with rheumatoid arthritis for my whole life, it started about in my early 30s back in the 90s. I would have my hand swell up to big red balloons around my knuckles and I wouldn't be able to move the hands at all. What I did notice that helped relieve the pain, but not the swelling was Absorbine Jr. The arthritis cream made it easier with the stiffness and the pain when I had the worst conditions. The swelling and the movement were still bad though and sometimes that made it hard to do the easiest of tasks around the house. The thing I noticed at first and the early signs were pain and the swelling. The swelling where my knuckles would get red where the first indications that I had rheumatoid arthritis I searched for alternative treatments and started on rheumatoid arthritis herbal formula i ordered from Health Herbal Clinic, my symptoms totally declined over a 5 weeks use of the rheumatoid arthritis disease natural herbal formula.i read reviews from other previous patients who used the herbal formula,i am now active, i can now go about daily exercise!! Visit there website www. healthherbalclinic. net or email Info@ healthherbalclinic. net herbs are truly gift from God.

Forget about cartilage -- it is the ligaments, tendons and connective tissues. These are a source of gelatin. I have found that gelatine works wonder for my own osteoarthritis -- glucosamine and chondroitin made NO difference at all.
I add a teaspoon of powdered gelatine per dog to my dogs meals. This I stared to improve the health of their coats. None of my dogs has had arthritis since I've been doing this. (Might be luck of course, though)

For myself I dissolve a teaspoon of the powdered gelatine into a warm drink (I prefer ginger cordial).

Great article. There are really so many options nowadays when it comes to treating these different conditions, I'm happy to see that lots of people are going the natural route instead of chemicals! Our dog tore her ACL last year and we didn't go with surgery. Instead our vet recommended restricting her activity and also using an Ortocanis dog knee brace to help stabilize the knee and increase blood circulation as a way of reducing her pain and helping her to heal.

The conservative method for us worked, and a year later she's doing great. She definitely still has stiffness in the mornings and after longer walks she may have a slight limp, but whenever this happens we pop on the Ortocanis knee brace and it usually makes a noticeable difference in her walking.

I think it's a great alternative for arthritic dogs or dogs having any type of joint problems. The one we found was reasonably priced and a year later it's still in great condition.

Brilliant article! Thank you. My chocky lab had a full cruciate tear when she was 6. She is now ten and a half, and (touch wood!) still comfortable and mobile. We were told she would need to be permanently on Metacam for the arthritis that rapidly set, but it affected her stomach. Instead I gave her Synoquin with her morning meal, and Cortaflex (vet strength) with her evening meal. I keep Metacam in stock, just in case. I order Cortaflex online (from Viovet) so it's loads cheaper than from the vet's. Big relief when supplements started working (around the four week mark). Looking back, at the first sign of arthritis, I also used Cortaflex for my other lab. She lived 'til she was nearly 14 without any further sign of stiffness or pain. Metacam seems to suit a lot of dogs, but not mine. Recently my young spaniel/poodle cross was neutered, and he, too, reacted badly to Metacam. Tramadol seems a safer way to go for post surgical pain. By the way, I'm from the UK.

Just a quick suggestion for joint aches-both dog and human.
I cooked beef ligaments and tendons to a broth in the crock for about 2 or more years. Didn't do a thing. Then, summer 2014 it was too hot so I mashed them up-lots of work, now have an electric grinder, second hand store.
I have to carry my Sadie up and down stairs. Within three days or less my Corgi was running up the stairs. (I still continue to carry her.)
I then tried them myself (they taste like elastic bands) and my joint pain was eighty per cent better within a few days.
Sadie is just turned 15, mid-January and she is now losing control over her legs, they sit funny, but she doesn't seem to be in pain.
I get my ligaments and tendons from a Chinese grocery store. She gets about an ounce with each of her two meals.
Namaste and care,
mhikl

Dear Mary,
Thank you, this is an excellent thorough article. I will be able to get started with our 20 month old pup who we have just diagnosed with arthritis. I am very grateful for your research and time to help others.
Best wishes x

Hi there. My 4yr old GSD was just diagnosed with moderate arthritis in his right elbow, along with elbow displaysia. He also has hyper-laxicity(?) in the ankle on the right leg. They want to do carpal orthodisis surgery on the right leg, but it will not help with his lameness. I have slowly been introducing Recovery SA into his diet, we are up to dosage for an 80lb dog and he is 100lbs. After reading this, I am thinking I should've just started high with the dosing, but he has a sensitive stomach. He is not overweight at all. This ADEQUANE people are mentioning, is it a natural product or pharmaceutical? I am hoping to keep him off pharmaceuticals for a few years, I think 4 is too young. So far, nothing is helping him though. I am trying cold laser treatments, we just had our 4th. I will be taking him for shockwave treatment in a couple of weeks and we are off to the holistic vet next week to try acupuncture & chiropractic treatments. Any additional advice would be so appreciated. He cannot do raw diet, as he got aggressive on it. Thank you

Dear sir / mam,
I am a resident of India and my dog has been recently diagnosed with arthritis. He is 6 years old and has been limping for the past 3 weeks. He had a problem in his left leg which now seems as recovered after due treatment but unfortunately the pain has shifted to his right leg and is not going away. He is a dalmation and a very active dog, it is difficult to control him at times. I would like to know the medications that would be available in india and also what exercises other than walking or swimimg can be done to improve his pain. Really need your help.
Thank u

I was giving my dog MSM and glucosamine and chondroitin for his arthritis but it didn't seem to help a lot. I refused the Rimadyl because of the damage it causes to every other organ of his body. I started using these antioxidant treats that were all natural and made here in America. I am not lying when I say that my 15 year old dog started jumping and playing like he was a pup again....after just one week! I highly recommend them. I found them on YouTube after watching a video that a lady made about her paralyzed dog who started walking again bc of this product.

Our 11 1/2 yr old Rottie has been on glucosamine and chondroitin for a long time and we asked about adequan. As soon as he started getting the shots he went downhill and got worse.. He ended up staying the nite and costing over $400. With still no sure diagnosis... A few years ago he was xrayed and the arthritis discovered all along his spine but he has gotten worse. Now he limps and can hardly get up and down. He is overweight due to a thyroid problem.. But we are careful with his food intake only he doesn't lose weight. Not being able to move much doesn't help that problem much.. Thank you for your article.. will look into trying other things mentioned..

@Elisabeth: Adequan was mentioned, along with Cartrophen. Indeed, MSM was not mentioned. I recommend it, and take some myself as it has an antiinflammatory action, without the side effects of NSAID. You can even take it with IBD. They did not talk about other modalities such as homeopathy, acupucture or therapy laser, all of those can provide relief of pain.

I wished you had touched on MSM more thoroughly (an anti-inflammatory) that works very well. My holistic vet recommended working UP to (2) 1000 mg doses per day for a 75 lb dog with stiffness (but no hip dysplaasia).

You should also NOTE a warning that any product containing glucosamine will increase blood sugar, if one has a diabetic dog.

Lastly, you did NOT discuss Adequan, which was a major diservice. This is an injectable glucosamine product that gets into & treats the joints MUCH more effectively than the glucosamine OTC supplements, that have to go through the digestive tract. Adequan helps restore or build new joint cartilage and it provides cushining synovial fluid. There was a shortage for some months but it is available again. I've seen dog after dog (unable or barely able to walk) become able to move remarkably well after the loading doses. It is not a cheap product, but after the loading series, you can use it once a month & many people buy it from the vet & give it themselves, to save money. It has been used for over 20 years in dogs & longer in horses. It has a very safe track record. many folks seem to find, it works better than similar injectable products such as Ichon.

Great article! Another fantastic alternative to the NSAIDs that I have found is a supplement called Hubrihound. It uses green lipped mussels from New Zealand and has worked wonders for my Pyrenees. Just a few years ago she was virtually immobile and today she has no apparent signs of pain or arthritis. Just as you said above, diet and exercise are critical as well, but if there are any dog owners out there that opt for the holistic route to help with their dogs pain or to even use as a preventative, then I highly recommend this supplement.

This article has great information about nutritional supplementation for arthritis and confirms the amazing results we got with Nusentia's products for our Springer Spaniels. The female had the biggest issue, and became like a puppy again, running around, we couldn't believe our eyes.

We started her our on Spectrin, which is an antioxidant/vitamin liquid with glucosamine for joint support. Their fish oil is top notch too, which is pure and has high values of EPA/DHA.

I didn't realize bromelain and other enzymes assist with inflammation, we supplement with Enzyme Miracle, we thought just for digestion, but this explains why her health got such a boost with these three products. Not to mention her skin and coat look better than ever.

I'm glad we haven't had to resort to any NSAIDs or pain relievers yet.

"he still enjoys one- to two-hour walks every day" What??!! That is way too much for an arthritic dog. And don't say he's enjoying them or he wants to go. Your dog will do whatever he thinks you want him to do and, yes, he wants to be outside. But necessarily walking for an hour each time.

Give him a break. He shouldn't be inactive but better an additional half-hour walk than hour-long walks. Horrendous.